Congress Must Act to Prevent Medicare Cuts in 2025 Physician Fee Schedule

AMGA Also Urges Action on Telehealth Payment Parity 

Alexandria, VA – AMGA today called on Congress to prevent pending cuts to the Medicare conversion factor, which will hinder the ability of multispecialty medical groups and integrated systems of care to provide high-quality care to their patients. As detailed in the Centers for Medicare & Medicaid Services (CMS) proposed 2025 Physician Fee Schedule rule, the conversion factor will be reduced from $33.29 to $32.36 for 2025, a 2.8 percent decrease. This proposed conversion factor will result in reduced payments, potentially forcing providers to limit services or delay investments to support value-based care models.

AMGA expects CMS will finalize this proposed cut in the conversion factor, meaning Congress must act to prevent it from taking effect.

 “The proposed cut illustrates the need for Congress to rethink the current reimbursement system,” said AMGA President and CEO Jerry Penso, MD, MBA. “This annual cycle of cuts needs to stop. Congress should prevent this cut from occurring and then work with stakeholders to reform the Medicare payment system for professional services so it provides stable, predictable payments that support providers’ ability to treat their patients.”   

AMGA recently surveyed its membership on what actions they would be forced to take if these Medicare cuts were implemented next year. They also were asked about what actions they took in 2023 in reaction to previous year’s Medicare cuts. Twenty-four percent of AMGA respondents either furloughed or laid off employees in 2023. Forty-nine percent of respondents said they will be forced to furlough or lay off employees in 2024 if the cuts continue. Also, 44% of these provider groups eliminated services to Medicare patients in 2023, and 65% expect to continue doing so in 2024 if cuts are implemented. Twenty-one percent of respondents instituted delays in social determinants of health investments, and 57% are expected to continue these delays in 2024 if cuts continue. The survey is available on the AMGA website.

Telehealth Payment Parity and Extension of Regulatory Waivers

In rulemaking last year, AMGA strongly endorsed CMS’ decision to finalize a telehealth payment policy that treats telehealth care as equivalent to in-office care. However, despite the lessons learned from the COVID-19 public health emergency (PHE), the underlying law has not been updated to ensure the flexibilities and payment parity in place during the PHE are available beyond the end of the year. Congress should codify the geographic and site of service flexibilities, along with payment parity, so patients will continue to maintain access to this vital service. The cost of treating patients through telehealth does not differ from an in-person visit, and AMGA strongly encourages Congress to ensure CMS has the authority to continue to reimburse telehealth and audio-only care appropriately.

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About AMGA

AMGA is a trade association leading the transformation of healthcare in America. Representing multispecialty medical groups and integrated systems of care, we advocate, educate, innovate, and empower our members to deliver the next level of high performance health. AMGA is the national voice promoting awareness of our members’ recognized excellence in the delivery of coordinated, high-quality, high-value care. More than 175,000 physicians practice in our member organizations, delivering care to one in three Americans. 

AMGA represents medical groups and integrated systems of care. Its diverse membership includes multispecialty medical groups, integrated delivery systems, accountable care organizations, and other entities committed to improving healthcare outcomes. AMGA advocates for the formation of innovative, clinically integrated systems of care that advance population health, enhance patient experience, and reduce healthcare costs. For more information, please visit www.amga.org.